Assessing the effectiveness of AFB smear versus GeneXpert MTB/RIF and real-time PCR in diagnosing tuberculosis at Hue University of Medicine and Pharmacy Hospital

Tạp chí Y học lâm sàng Bệnh viện Trung Ương Huế - Tập 17 Số 2 - Trang 84-89 - 2025
Hoàng Bách Nguyễn1, Thi Bao Chi Le1, Thi Chau Anh Nguyen1, Thị Khánh Linh Nguyễn1, Văn Bảo Thắng Phan1, Thị Quỳnh Tâm Trần1, Nữ Xuân Thanh Lê1, Thị Hải Đinh1, Thị Đăng Khoa Nguyễn1, Thị Tuyền Nguyễn1, Thị Thuỷ Ung1, Đức Hoàng Sang Nguyễn1, Thị Tuyết Ngọc Trần1, Thị Minh Ngọc Hoàng2, Thị Ngọc Mai Dương2, Viết Quỳnh Trâm Ngô1
1Bộ môn Vi Sinh, Trường Đại học Y-Dược, Đại học Huế
2Khoa Vi Sinh, Bệnh viện Trường Đại học Y-Dược Huế

Tóm tắt

Background: Tuberculosis (TB) remains a major global health challenge, with early and accurate diagnosis being critical for effective disease control. Traditional acid-fast bacilli (AFB) smear microscopy has limited sensitivity, particularly in smear-negative cases. The advent of molecular techniques, such as the GeneXpert MTB/RIF assay and real-time PCR, has significantly improved the rapid detection of Mycobacterium tuberculosis (MTB) and rifampicin resistance. Methods: A total of 368 patients suspected of tuberculosis (TB) were analyzed using three diagnostic methods: AFB smear microscopy, GeneXpert MTB/RIF, and real-time PCR. Patient samples were collected from multiple hospital departments and categorized by demographic characteristics. AFB smear was performed using Ziehl-Neelsen staining, while GeneXpert MTB/RIF and real-time PCR were conducted following manufacturer protocols. Sensitivity, specificity, and positivity rates for each diagnostic method were compared to assess their effectiveness in detecting TB cases. Results: A prospective study at Hue University Hospital (2023-2024) compared TB diagnostic methods in 368 patients. AFB smear microscopy detected only 7.6% of cases, while GeneXpert MTB/RIF and real-time PCR identified 6.3% and 20.5%, respectively. GeneXpert demonstrated 100% sensitivity/specificity, outperforming AFB (10% sensitivity) and PCR (82.1% sensitivity, 100% specificity). Most cases were in respiratory (18.4%) and infectious disease (16.1%) departments. Conclusion: Findings highlight the critical role of molecular methods like GeneXpert and PCR in improving TB detection and urge their integration into routine screening to optimize early diagnosis and treatment.

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Tài liệu tham khảo

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Tạp chí Y học lâm sàng Bệnh viện Trung Ương Huế

Tập 17 Số 2

84-89

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